Holter-Detected Arrhythmias in Acute Exacerbations of COPD: NT-proBNP Correlates and Hypercapnia Associated with COPD-Related Readmission.
- 1Department of Cardiology, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, 519000, People's Republic of China.
- 2Department of Cardiology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510163, People's Republic of China.
- 3Department of Cardiology, The First Affiliated Hospital of Guangzhou Medical University, China State Key Laboratory for Respiratory Disease, Guangzhou, 510120, People's Republic of China.
Abstract
Background
Cardiac arrhythmias are increasingly recognized during acute exacerbations of chronic obstructive pulmonary disease (AECOPD), but their full spectrum and prognostic significance detected by continuous Holter monitoring remain insufficiently characterized.Methods
We conducted a single-center retrospective cohort study of patients hospitalized for AECOPD between April 2022 and January 2025 who underwent continuous Holter monitoring. Arrhythmias were classified as atrial arrhythmias (AA), atrial fibrillation/flutter (AF/AFL), ventricular arrhythmias (VA), or coexistence of ≥2 arrhythmia types. Multivariable regression models were used to identify factors associated with arrhythmias and clinical outcomes. COPD-related readmission was assessed using Kaplan-Meier and Cox regression analyses.Results
Among 548 patients, 60.4% experienced at least one arrhythmia during hospitalization. AA (37.6%) was the most frequent subtype, followed by VA (31.0%) and AF/AFL (12.2%), while 21.5% exhibited multiple arrhythmia types. Older age, male sex, higher heart rate, elevated NT-proBNP, and larger left atrial diameter were independently associated with in-hospital arrhythmias. NT-proBNP was consistently associated with all arrhythmia phenotypes and demonstrated moderate discrimination for arrhythmia identification (AUC=0.730; cutoff, 131.5 pg/mL). AF/AFL was independently associated with prolonged hospitalization (adjusted ratio=1.26, P=0.010). After accounting for the time-dependent effect of age, hypercapnia (PaCO₂ ≥45 mmHg) remained associated with a higher risk of COPD-related readmission (adjusted HR=1.85, 95% CI 1.19-2.88; P=0.007).Conclusion
In-hospital arrhythmias are highly prevalent among patients hospitalized for AECOPD. NT-proBNP is consistently associated with multiple arrhythmia phenotypes and may aid arrhythmic risk stratification. Hypercapnia, but not arrhythmia status, remained independently associated with COPD-related readmission despite the limited sample and observational design.
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BibTeX
@article{ding2026holterdetected,
title = {{Holter-Detected Arrhythmias in Acute Exacerbations of COPD: NT-proBNP Correlates and Hypercapnia Associated with COPD-Related Readmission.}},
author = {Nan Ding and Jinmin Chen and Weida Qiu and Yao Lu and Zeyue Chen and Ruli Cai and Ailan Chen},
journal = {International journal of chronic obstructive pulmonary disease},
year = {2026},
month = oct,
doi = {10.2147/copd.s642161},
url = {https://europepmc.org/article/MED/42928902},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Holter-Detected Arrhythmias in Acute Exacerbations of COPD: NT-proBNP Correlates and Hypercapnia Associated with COPD-Related Readmission.
AU - Nan Ding
AU - Jinmin Chen
AU - Weida Qiu
AU - Yao Lu
AU - Zeyue Chen
AU - Ruli Cai
AU - Ailan Chen
PY - 2026
DA - 2026/10/21
JO - International journal of chronic obstructive pulmonary disease
DO - 10.2147/copd.s642161
UR - https://europepmc.org/article/MED/42928902
AB - Background Cardiac arrhythmias are increasingly recognized during acute exacerbations of chronic obstructive pulmonary disease (AECOPD), but their full spectrum and prognostic significance detected by continuous Holter monitoring remain insufficiently characterized.Methods We conducted a single-center retrospective cohort study of patients hospitalized for AECOPD between April 2022 and January 2025 who underwent continuous Holter monitoring. Arrhythmias were classified as atrial arrhythmias (AA), atrial fibrillation/flutter (AF/AFL), ventricular arrhythmias (VA), or coexistence of ≥2 arrhythmia types. Multivariable regression models were used to identify factors associated with arrhythmias and clinical outcomes. COPD-related readmission was assessed using Kaplan-Meier and Cox regression analyses.Results Among 548 patients, 60.4% experienced at least one arrhythmia during hospitalization. AA (37.6%) was the most frequent subtype, followed by VA (31.0%) and AF/AFL (12.2%), while 21.5% exhibited multiple arrhythmia types. Older age, male sex, higher heart rate, elevated NT-proBNP, and larger left atrial diameter were independently associated with in-hospital arrhythmias. NT-proBNP was consistently associated with all arrhythmia phenotypes and demonstrated moderate discrimination for arrhythmia identification (AUC=0.730; cutoff, 131.5 pg/mL). AF/AFL was independently associated with prolonged hospitalization (adjusted ratio=1.26, P=0.010). After accounting for the time-dependent effect of age, hypercapnia (PaCO₂ ≥45 mmHg) remained associated with a higher risk of COPD-related readmission (adjusted HR=1.85, 95% CI 1.19-2.88; P=0.007).Conclusion In-hospital arrhythmias are highly prevalent among patients hospitalized for AECOPD. NT-proBNP is consistently associated with multiple arrhythmia phenotypes and may aid arrhythmic risk stratification. Hypercapnia, but not arrhythmia status, remained independently associated with COPD-related readmission despite the limited sample and observational design.
SN - 1176-9106
SN - 1178-2005
ER -